Analysis: PEER proposes review of trauma care cost

JACKSON, Miss. (AP) — Two incidents that occurred within months of each other prompted Mississippi public health leaders and lawmakers to invest in a trauma care system.

On Nov. 5, 1995, Gov. Kirk Fordice was severely injured when his sport utility vehicle ran off Interstate 55 north of Grenada and flipped over. He was transferred to the University of Mississippi Medical Center in Jackson, the state’s only Level I trauma center.

On Feb. 27, 1996, Lt. Gov. Ronnie Musgrove and state Trooper Mike Wilkie were injured in Simpson County when a van broadsided their state vehicle. Musgrove also was taken to UMMC.

In the wake of those accidents, the Legislature in 1997 set up a trauma care task force to make recommendations. In 1998, lawmakers approved statewide trauma care system.

The system was funded with a $5 assessment on speeding and DUI tickets, which was estimated to bring in $2 million annually.

In signing the bill in 1998, Fordice said the creation of a trauma system was inevitable, but “I guess what these two high-profile automobile accidents did was give the impetus to get it done now.”

Musgrove said: “Anytime you’ve had a personal experience and you’ve been fortunate enough to survive, you recognize how important it is for everyone to have that same opportunity.”

In 2008, the Legislature boosted assessments on a variety of traffic violations, motor vehicle and ATV/motorcycle tags and specialty tags. The Legislature does not appropriate money to the program.

In the past four fiscal years, funding for the trauma care system has average more than $20 million from all sources.

Mississippi’s trauma care system rates hospitals from Level 1, the highest, through Level 4, the lowest, based on the types of facilities and physicians they have available. Each trauma center must provide and meet certain standards of care as part of the designation process for licensing.

UMMC is the only Level 1 trauma care facility in the state. A Level 1 facility has research and academic medical centers with specialists present 24 hours a day. Other Level 1 facilities in Mississippi’s network — though not in the state — are the Regional Medical Center and Le Bonheur Children’s Hospital, both in Memphis, Tenn., and the University of South Alabama in Mobile, Ala.

There are four full-time Level 2 hospitals. They’re in Hattiesburg, Tupelo, Gulfport and Pascagoula.

Seventy-nine in-state hospitals, one in-state burn center and three out-of-state hospitals were participating in Mississippi’s trauma system as of Feb. 5, according to a newly released report from a legislative committee.

Mississippi State Department of Health figures show that between 2000 and 2010, the ratio of trauma deaths versus traumatic injuries in Mississippi improved. One factor affecting the percentage, health officials said, was improvement in the pre-hospital methods for routing a trauma patient to the appropriate hospital.

In its report, the Performance Evaluation and Expenditure Review Committee recommended the Department of Health come up with proposals and a timeline to cover gaps in the trauma care system, especially in the coastal and southwest regions of the state.

State health officer Dr. Mary Currier said the agency will do that and also address PEER’s concerns about the cost of running a trauma center and the cost of uncompensated trauma care.

Hospitals in the trauma network receive payment from the state for uncompensated trauma care for patients who lack insurance or the ability to pay for treatment.

PEER said the current funding system provides flexibility to target trauma needs but is not sufficient to cover network participants’ uncompensated care costs. PEER said funding also does not help hospitals reach higher levels in the network.